Bittersweet Realities

Pulling out onto Arapahoe just after midnight, I felt awash with conflicting emotions.  It was something I’d done countless times but it felt so different.  The pavement was smooth and black.  There were street lights. The avenue was broad.  Driving women in labor to the hospital was, of course, my job for quite some time.  Next to me, Amanda held her belly through the increasing contractions as we quietly rolled towards Boulder.  In between the pains, we joked and made light conversation.  In the back of my mind a reel of images began to play; a road washed out by monsoon rains, casually edging an ambulance along the crumbling rim of a landslide, a young husband rocking back and forth holding the mother-to-be.  In the background of my mind a subtle track hummed in time; the sound of creaking leaf springs, the groans of the mother as we hit a deep pothole, the squeak of seat and rumble of road.  In the foreground, there was barely a sound.    
I thought of Puran, Simon and Saran who were, more than likely, engaged in that same activity half a world away.  “More than likely” is appropriate to use here given the political climate in the Darjeeling District.  During the month of August, the roads and shops were open a grand total of 6 days.  The rest of the month had been disrupted by “general strikes” which are used as a tool to demand separate statehood for “Gorkhaland”.  During these protests, only hospitals and pharmacies are allowed to open their doors.  Only ambulances are allowed to ply the roads.  Our drivers were running non-stop,  ECTA’s ambulances being the only link for rural villages in times of emergency.  Saran alone transported 36 laboring mothers in August, each trip requiring 6-8 exhausting hours. His wife Binnu is expecting their first child herself later this year, so he can appreciate the need of those he serves.
As a cordial nurse, checked Amanda and I into the calm, quiet, clean and comfortable L&D at Boulder Community Hospital my mental screen played on; memories of having to bang on shuttered gates and locked doors in the middle of night, memories of terse nurses annoyed that we hadn’t “waited till morning” despite the emergency, memories of scared fathers thumbing through their rupees wondering how they would eat.  Our room was spacious and homey complete with TV, DVD and free WiFi… not to mention a private bathroom.  Despite being overjoyed that we were about to meet our new child, an ache crept into my heart remembering… remembering a single overflowing latrine for 60 women, remembering no running water, remembering women laboring on soiled mattresses strewn on the floor of the Government Hospital.  Not only did Amanda have a large, clean adjustable bed… but I, with no medical needs at all, had a sofa sleeper to retire on incase I fancied a little shut eye.
The equipment at the ready just in our room, just for Amanda, exceeded what would be available in an entire L&D at the tertiary level in our District of W.Bengal which sees 40-50 deliveries a day.  In comparison to the 3-4 nurses on duty for all those women, an entourage was assembling for Amanda’s VBAC.  Hospital policy required a surgeon and anesthesiologist to be on call.  Three different nurses assisted us throughout the night and a nurse midwife was present for the delivery.  After a short and beautiful labor, Amanda gave birth to our first daughter, Juniper Sahara, at 5:16am.  Finishing the requisite phone calls and postpartum care, Amanda rested in her clean warm bed.  I, with a grateful heart, drifted off to sleep on the comfy sofa with my baby girl tucked in beside me.  Later, I awoke to the visit of the Pediatrician.
I’ve experienced this intense bittersweet emotion with the birth of each of our children.  After Asher’s birth via emergency C-section, I tasted the joy of my first born as well as the realization that, if I’d been born a Nepali villager, I would be a widower.  With the miscarriage of Leaf Anjali, we experienced the bitter reality of substandard care and lack of access to emergency services as well as the sweetness of finding redemption even in that traumatic event.  With Shepherd Ketan, Cedar Milan and now Juniper Sahara we experienced the joy of competent compassionate care in three very different contexts; a homebirth in America, a homebirth in a remote Indian village and a midwife assisted hospital delivery in Colorado.  My joy and gratefulness in these 3 births has not been diminished by but instead tempered with the reality that my friends, neighbors and loved ones in India still do not have access to the standard of care they deserve.  Our projects have brought them a few steps closer, but there is still a long journey to actualize holistic maternal/child care in South Asia.
A few days after Juniper’s birth, an unprecedented storm settled in on Boulder releasing a year’s worth of rain in under a week.  Roads were washed out in this ‘monsoon’, landslides cut off mountain routes, people in remote towns had to walk hours in the rain to reach the nearest vehicle accessible road.  Sounding very familiar, it dawned on me how similar Boulder is to Siliguri.  It is the last town in the plains before the mountains.  It is the place to come for all the essential services the folks “in the hills” need.  For two weeks, our home in America tasted the reality that our home in India faces for 5 months of every year.  The effects will last for months, maybe even years but there are some stark differences.  This was a hundred… and some even say thousand… year flood.  There is nothing on record which even comes close.  The Himalayas will experience six times the rain this every year, not to mention every summer.  Where we have emergency airlifts and FEMA, Himalayan villagers have their own two legs and arms.  I do not mean to diminish the suffering which Coloradans have experienced but simply hope to elucidate the unimaginable reality of so many living half a world away.
One huge leap Amanda and I were able to make in linking Himalayan mothers with the care they need (especially in the heart of monsoon with all its perils) was getting “The Donkey” recognized as a Matriyaan Ambulance.  Through this government sponsored program we are able to provide free transport to mothers to and from the hospital.  One huge obstacle we’ve faced has been political grid lock in the region.  ECTA/HIMserve has not received any reimbursements for our services since March.  The cost for over 150 maternal transports has been flowing out of pocket and eroding our budget for the school and Community Health Volunteer training program.  Some other local Matriyaan providers have buckled under the financial burden.  Our vehicles have been able to provide unbroken service thanks to the support of our donors.  Matriyaan has been tremendously successful in ensuring free access to essential medical services for families of every income bracket… but a government shutdown forced by partisan politics is threatening to reset the only tangible progress which has been made in the last decade.  Just as the acute emergency of the Colorado floods reflects the chronic state of emergencies caused by the monsoon in India, I awoke this morning to find that our national politics are not so very different than the perpetual division and corruption which paralyzes India.  Now Americans face a government shutdown as well.  In both contexts, public health seems to be the collateral damage.
While it is tempting to focus on the bitter we can savor the sweet just as easily.  We can do more than savor it; we can share it.  We can do more than share it; we can create it.  Here at ECTA we hope, pray and work to ensure that every mother, father and child can be “Born into love, Live in hope and Die with dignity”.  Please take time to consider your roll in supporting this endeavor.  ECTA needs to raise $1,500 dollars of recurrent monthly donations by the end of the year to make up for the Matriyaan deficit, maintain the organization and lay the groundwork for future initiatives.  Every little bit helps.  Automatic recurrent donations of $15, $25 or $50 dollars add up to meet our monthly goal.  Donate at www.ecta-international.org/donate.html knowing that no one can truly be healthy, unless there is health for all.
Sincerely,
Ryan Phillips – Executive Director of ECTA International

An Hour Before Sunrise

                Whenever I travel via Kolkata (Calcutta) I have a tradition.  I like to wake up an hour before sunrise and walk the alleyways.  My path often leads me past the large market near Sudder St.   The streets are full of thousands of the homeless sleeping under porticos, on top of food carts, along the sidewalks or, during the hot months, in the middle of the road.  After waking, they rub their aching backs and then their lives unfold entirely in public; they bathe in the street, brush in the street, dress in the street, buy a cup of chai and start their day in the street.  Where will they go to work?  What will they do all day?  I watched one such man put on his sandals, roll up his mat, tuck it in the bottom of his food cart, pull out a stove and wok to start cooking atop where he’d spent the night.  He was still there cooking pakora when I passed by late that evening.  When I walk by in my sneakers and travel pants they probably wonder why a “man of privilege” is sauntering around their sphere of poverty.  Perhaps they think I’m just there to “slum it up” for a morning… as yet another passing diversion.

                Here in America I now have a new tradition.  I wake up an hour before sunrise and ride the streets.  On my bicycle, I short cut through the Walmart parking lot on my way to work.  The homeless are there sleeping in old Buicks, ramshackle RV’s, old vans with black garbage bags taped over the windows and in the backs of pick-ups covered by homemade plywood toppers.  Few realize that the Walmart parking lot is one of the only places that people are legally allowed to camp in their vehicles overnight for free.  As I ride by, they wake up.  Where will they go to work?  What will they do all day?  They rub their backs, which ache from sleeping in the passenger seat, before wiping the condensation from the windshield.  As they look through the fogged glass perhaps they see me as just another “man of privilege” out for some morning exercise on his road bike.  But I’m not out for exercise, I’m going to work as well.

                Many of the men who seem so poor in the streets of Kolkata, view themselves as one of the ones who’ve made it.  They’ve left families behind in the far flung villages of Bengal, Bihar and Orissa.  They cook samosa and sell chai all day.  They sleep in the street to save money… so as to send it home to their families.  Their families often have no fertile land or are uneducated and therefore unemployable.  Their kin are eating while many of the neighbors are not.  While the tourists to Sudder St. view them with pity, they may actually feel a sense of pride.  They are feeding large families back home thanks to those four rupee cups of chai and two rupee cups of “ice cold lemon water”.  Even better off are the bicycle rickshaw drivers.  Many, myself included, grimace as they see an emaciated old man pedaling and sweating, in the kind of heat that only Kolkata can produce, conveying a fat merchant to his shop.  But how does that rickshaw-walla feel about himself?

                Yesterday, the sun was hot as I picked vegetables.  The sweat ran down and stung my eyes.  I work on a local organic farm making just a bit over minimum wage.  Few realize that there is no overtime pay or health benefits in the agriculture sector.  It’s codified.  The pay is meager and the work is hard.  Occasionally, a volunteer will come that wants to work a few days to get his or her hands dirty, to ‘reconnect’ with the earth they are estranged from or perhaps just, ‘slum it up’ for a few days.  Recently, a professor of songwriting from a large university came to work with us.  We became engaged an interesting conversation about modern life and incomprehensible trends in our culture.  At a certain point, he gave me a quizzical glance and asked me about my educational background.  After giving him a very abridged account of my studies and work he responded in a rather surprised tone,

“Oh… I guess I just expected that those working on a farm were, you know, high school drop outs and those who didn’t have any other option.”

I responded, “Well Nick over there just finished his Master’s in Biochemistry, Leah has a P.H.D in the clarinet, Steve used to play Tuba for the New York Symphony and, as far as I know, all of us are here by choice.  We love our jobs and prefer a rich life to a rich pocketbook.”

The truth is that I actually do like picking vegetables out in the hot sun.   I like getting dirty, sweating and not having a car to drive to work in.  I like my life, even with all its discomforts and many frustrations.  I’m free to live according to my convictions about the environment, society, culture, agriculture, nutrition etcetera.  Leo Tolstoy put it best when he wrote, “There is nothing more intolerable for a man than to live in contradiction to his convictions.”  So, I feel rich.  I feel like a man of privilege.  But when others see me riding home from work in my muddy Carhartt’s, on a hand me down bicycle laden with blemished vegetables… they probably assume me poor.  By most governmental and social indicators, I am poor.  I earn less than the national poverty threshold, take classes from the community college, my kids eat ‘free lunch’, we shop at Goodwill and receive WIC and MEDICAID.  The experts say I’m poor and many members of the political establishment and public consider “folks like me” a drain on society and the economy.   So am I? 

The numbers do not reflect the environmental value of choosing to live simply.  The public health stats do not assume that my kids eat better, and by better I mean healthier not more, than many of those in higher brackets.  Those who suppose the poor to be parasitic do not know that I run a non-profit on a volunteer basis.  The social workers would not guess that I’m prepping for med school as well with the intention of bringing high quality healthcare to the Himalayas.

                Occasionally, as we lived in remote villages in the Himalayas over the years, a western tourist would stumble across our path… literally.  More often than not, I’d be wearing the same Carhartt’s muddy from building a school, trail, a health clinic or just simply farming.  Like the professor volunteering at the farm, their curiosity would be peaked and would want to know my backstory.  Amanda would often invite them over to our mud floored cabin, lacking electricity or running water, for a cup of tea.  Almost everyone had the same reaction, “Man, I’ve always wanted to do something like that, something that really mattered.  To live someplace like this.  I’ve just… just… never been able to.”  By all indicators we were poor in that context, so why were we considered rich by our guests?

                I’m a rich man.  I’m rich because I’m healthy and loved, have incredibly supportive family and friends, am the citizen of a country which supports its citizens in all seasons, am able to live according to my convictions and have the freedom to pursue a better life for myself as well as my neighbors near and far.  I have found again and again, around the world that the poor have a beauty and a richness to share.  Like the rich, the poor want to share that richness but have “just… just… never been able to.”  When we co-founded ECTA, our mission was to show rich and poor alike that we are “able to.”  The lines between rich and poor are blurrier than we imagine, highly based on context and perception.  Unfortunately, most people allow the narrowness of their contexts to invisibly limit the possibilities.  Throughout the years we have worked with an incredible array of characters.  We’ve seen patients become caretakers, struggling students become teachers, farmers become community developers, mothers become midwives, drop-outs become ambulance drivers, the malnourished become strong healthy individuals, the poor become rich and the rich become poor to make it all happen.

                I’ve had to reinvent myself as of late as an “older student” and now the Executive Director of ECTA International.  ECTA is growing, changing and reinventing itself as well.  Check in on our website, www.ecta-international.com to see our redefined mission and vision.  Follow us on Facebook to keep up with current events and to discover articles on issues related to our work.  Look to yourself to discover what your part is in ensuring that “All can be born into love, live in hope and die with dignity” rich and poor alike.